Recurrent wheeze and cough in young children: is it asthma?

Ng, Mark; How, Choon How

doi:10.11622/smedj.2014064

Cited by 9 publications

(7 citation statements)

References 52 publications

(48 reference statements)

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“…Children who experience wheezing episodes also complain from diminished airway function, which substantially impacts their quality of life and aggravates the financial burden of the family 7 . Since it is a sensitive non-specific manifestation, wheezing represents a high expenditure on medical costs, including consultations, emergency department visits, utilization of healthcare resources, access to medical devices, consumption of prescription medications, and high rates of hospitalization 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Factors associated with wheezing among Lebanese children: Results of a cross-sectional study

Malaeb

Hallit

Sacre³

et al. 2020

Allergologia et Immunopathologia

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Background: In Lebanon, asthma is underdiagnosed due to low access to healthcare, particularly in rural areas, although asthma diagnosis in children is based mainly on clinical symptoms. Thus, wheezing might be more suggestive of undiagnosed respiratory diseases including asthma in Lebanese children. This study aimed to determine the factors associated with wheezing in Lebanese children without asthma diagnosis. Methods: This cross-sectional study was conducted between December 2015 and April 2016, enrolling a total of 1203 schoolchildren. Results: Out of 1500 prepared questionnaires, 1380 questionnaires were distributed in schools, and 1203 (87.17%) were collected back from the parents of children aged between 4-17 years old.The sample included 42 (3.5%) [95% CI 0.025-0.045] children with reported chronic wheezing. A multivariable analysis was performed taking the presence versus absence of wheezing in children as the dependent variable. The results showed that spraying pesticides at home (aOR=1.91), presence of humidity at home (aOR=2.21) and child reflux (aOR=2.60) were significantly associated with the presence of wheezing in children. Conclusion:The findings of the study suggest that certain environmental factors, such as pesticides, humidity at home and reflux disease, might be associated with wheezing episodes in children. Those factors can be prevented through raising awareness by health care professionals.

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Section: Introductionmentioning

confidence: 99%

Factors associated with wheezing among Lebanese children: Results of a cross-sectional study

Malaeb

Hallit

Sacre³

et al. 2020

Allergologia et Immunopathologia

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“…There is still a very clear lack of understanding of asthma in children under 5 years, and diagnosis of asthma within the preschool age is challenging due to the lack of proper guideline and definition (26). In this age group, symptoms of wheezing and cough are very common but may be the result of acute respiratory infections instead of asthma (Figure 3) (27, 28). The Tucson birth cohort (USA) identified three distinct phenotypes of wheezing in the first 6 years of life: transient early wheezing, late onset wheezing and persistent wheezing (29, 30).…”

Section: Diagnostic Challenges Across Agementioning

confidence: 99%

Asthma Across Age: Insights From Primary Care

Kaplan

Hardjojo

et al. 2019

Front. Pediatr.

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Asthma is a heterogeneous disease comprising of multiple phenotypes and affects patients from childhood up to old age. In this review, we summarize the current knowledge on the similarities and differences in asthma across different age-groups, with emphasis on the perspective from primary care. Despite the similar disease presentation, phenotyping studies showed that there are differences in the distribution of phenotypes of asthma presenting in childhood compared to that in adulthood. Whereas, asthma with early age of onset tends to be of the atopic phenotype, the disease shifts toward the non-atopic phenotypes at later ages. Studies within primary care patients aiming to elucidate risk factors for future asthma exacerbation have shown pediatric and elderly patients to be at higher risk for future asthma attacks compared to other adult patients. Regardless, both pediatric and adult studies demonstrated previous asthma episodes and severity, along with high blood eosinophil to predict subsequent asthma attacks. Differences in childhood and adult asthma are not limited to the underlying phenotypes but also extends to the challenges in the diagnosis, treatment, and management of the disease. Diagnosis of asthma is complicated by age-specific differential diagnoses such as infectious wheezing and nasal obstruction in children, and aging-related problems such as heart disease and obesity in the elderly. There are also age-related issues leading to decreased disease control such as non-adherence, tobacco use, difficulty in using inhalers and corticosteroid-related side effects which hinder asthma control at different patient age-groups. Several clinical guidelines are available to guide the diagnosis and drug prescription of asthma in pediatric patients. However, there are conflicting recommendations for the diagnostic tools and treatment for pediatric patients, posing additional challenges for primary care physicians in working with multiple guidelines. While tools such as spirometry and peak flow variability are often available in primary care, their usage in preschool patients is not consistently recommended. FeNO measurement may be a valuable non-invasive tool which can be adopted by primary physicians to assist asthma diagnosis in preschool-age patients.

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“…Children under age 4 were excluded since many of these children have other wheezing disorders that mimic asthma and are difficult to diagnose (e.g. viral bronchiolitis) 14,15 .…”

Section: Study Populationmentioning

confidence: 99%

Asthma Prevalence Among Medicaid-Enrolled Children

Smith

Serban

Fitzpatrick

2019

The Journal of Allergy and Clinical Immunology: In Practice

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Background: Small-area asthma prevalence measures, which are crucial for targeting interventions, are currently sparsely available for children.Objective: This study aims to provide measures of in-contact asthma prevalence for the 2012 Medicaid child population, to highlight areas in need of targeted asthma interventions.Methods: Using the 2012 Medicaid Analytic eXtract (MAX) claims files, we develop two prevalence metrics differentiated by persistent or diagnosed asthma. We develop prevalence measures at the state, county, and census tract levels, with statistical inferences to highlight areas of high-prevalence where intervention should be focused. We compare the measures to asthma prevalence estimates derived from a sample of the child population who have self-reported whether they have been diagnosed with asthma regardless whether in-contact.Results: 1.98 million (8.1%) and 1.71 million (6.9%) Medicaid-enrolled children are identified with in-contact asthma diagnosis and persistent asthma, respectively. Among 40 states, 17 have lower prevalence estimates for the Medicaid-enrolled children than similar Centers for Disease Control and Prevention (CDC) child asthma self-reported prevalence estimates. High prevalence regions span primarily in the southern Midwest region, from Texas to West Virginia and Illinois to north Florida. Conclusions:There are large variations in the differences between CDC self-reported estimates for the general population and the in-contact estimates for the Medicaid-enrolled children, highlighting potential asthma misdiagnosis in the Medicaid population in many states. Small area estimates point to areas of high prevalence, consistently throughout the south and southeast.

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Recurrent wheeze and cough in young children: is it asthma?

Cited by 9 publications

References 52 publications

Factors associated with wheezing among Lebanese children: Results of a cross-sectional study

Factors associated with wheezing among Lebanese children: Results of a cross-sectional study

Asthma Across Age: Insights From Primary Care

Asthma Prevalence Among Medicaid-Enrolled Children

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